Wertheim, Michael Stanley
Wertheim, Michael Stanley is an individual health care provider with primary practice located at 1871 Se Tiffany Ave Suite 100, Port St Lucie FL 34952-7585. He recently has only one registered license in Allopathic & Osteopathic Physicians / Hematology & Oncology, which is considered as his primary health care specialty. Wertheim, Michael Stanley can be contacted via phone (772) 335-5666.Contact Information
Primary practice address
1871 Se Tiffany Ave Suite 100
Port St Lucie FL 34952-7585
Phone: (772) 335-5666
Fax: (772) 335-4826
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Hematology & Oncology | 207RH0003X | 0046325 | Florida |
Profile Details
| NPI number | 1982643474 |
|---|---|
| LBN Legal business name | Wertheim, Michael Stanley |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 6th, 2006 |
| Last updated | Jun 16th, 2010 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1982643474 | NPPES |
| Florida | Other | 0046325 | FLORIDA MEDICAL LICENSE |
| Florida | MEDICAID | 047329400 | FLORIDA MEDICAL LICENSE |
| Florida | Other | 830003200 | FLORIDA MEDICAL LICENSE |
| Florida | Other | 56158 | FLORIDA MEDICAL LICENSE |
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